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Pharmacology > lecture 4 olympics > Flashcards

lecture 4 olympics Flashcards

1
Q

An older pt with severe gastroesophageal reflux disease (GERD) has had only minimal relief using histamin2-receptor antogonist (H2RA). The patient is to begin taking omeprazole. What will the nurse teach this pt ?

A

Long-term therapy may be needed

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2
Q

which organism or disorder is responsible for many cases of PUD

A

H. pylori

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3
Q

Which common drug for nausea and vomiting is a 5-HT3 receptor against antagonist

A

ondansetron

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4
Q

What is the purpose for the nurse administering metoclopramide (Reglan). IV postoperatively ?

A

Prevent postoperative nausea and vomiting

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5
Q

A pt who has had a myocardial infarction is advised to avoid straining with defecation. Which medication would be prescribed to this pt?

A

Stool softners

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6
Q

Which is the laxative of choice for an older pt who is in the end stage of Alzheimers disease and requires a daily laxative ?

A

Bulk forming

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7
Q

The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. The nurse will suggest that the parent discuss which medication with the child’s provider?

A

Polyethylene glycol

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8
Q

Pt prescribed metoclopramide reports having difficulty sleeping, difficulty concentrating, tiredness, and feeling hopeless. What is your best action ?

A

Hold the drug and notify the prescriber

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9
Q

Which treatment would be considered safe for an infant?

A

-Bulk forming laxatives
-Malt soup extract

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10
Q

The recovery room nurse is preparing to assist with the care of several postoperative pts. Which pt would the nurse prioritize care for regarding the potential for postoperative nausea and vomiting?

A

A 50 yr old woman undergoing a total hysterectomy with general anesthesia

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11
Q

What condition is occurring when pt experiences nausea immediately on entering the clinic to receive another course of chemotherapy?

A

Anticipatory nausea and vomiting

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12
Q

Which drug therapy is aimed at reducing gastric acid secretions?

A

-H2 antagonists
-Proton pump inhibitors

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13
Q

Pt newly diagnosed with PUD reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The nurse learns that the pt drinks 2 to 3 cups of coffee each day and has a glass of wine with dinner 3 or 4 nights per week. The pt eats three meals a day. The nurse will counsel this pt to:

A

change the meal pattern to five or six smaller meals per day

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14
Q

The nurse in a long term care facility is preparing to pass medications to the residents. To which of the following residents should the nurse administer an antidiarrheal ?

A

-An 80 yr old woman with diarrhea of sudden onset that has lasted 3 days
-A 92 yr old man with diarrhea secondary to inflammatory bowel disease
-A 70 yr old woman with a history chronic diarrhea from GI surgery

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15
Q

What problems may a pt with nausea and vomiting be at risk for ?

A

-weight loss
-dehydration
-electrolyte imbalance

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16
Q

Nurse receives an order to administer castor oil to a patient. Which action by the nurse is correct ?

A

Chill the medication and mix it with fruit juice

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17
Q

The nurse is caring for an older adult pt after a right hip open reduction internal fixation (ORIF). The pt is taking an opioid every 6 hrs as needed for pain. The nurse discusses obtaining an order from the prescriber for which medication ?

A

Docusate sodium

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18
Q

Why does the nurse monitor daily weights prior to the administration of antiemetic medications to chemotherapy pts?

A

Weight loss is a common adverse effect associated with chemotherapy, and dosages may need to be readjusted

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19
Q

What is the mechanism of action of a stimulant laxative ?

A

Irritates the intestine directly, promoting peristalsis and evacuation

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20
Q

Pt with renal disease is scheduled for colonoscopy. Before the procedure, the nurse will anticipate administering :

A

Polyethylene glycol and electrolytes

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21
Q

Which factors contribute to the development of PUD?

A

-cigarette smoking
-genetics
-h. pylori

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22
Q

Cimetidine (Tagamet) is an example of which class of drug ?

A

Histamine (H2) receptor antagonist

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23
Q

When the nurse assesses bowel habits in a patient, which is the best example of normal bowel elimination ?

A

Regular bowel elimination pattern of soft stool

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24
Q

Which medication is used in the treatment gastric reflux esophagitis and diabetic gastroparesis ?

A

Metoclopramide

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25
Q

You are giving discharge instructions to a pt who will be taking an antacid for gastric problems. Which instructions should be provided to this pt ?

A

-Antacids must be taken between meals
-Antacids should be taken at bedtime
-Antacids serve as a gastric buffer
-Antacids can cause diarrhea

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26
Q

A pt is receiving morphine for pain control. What will the nurse emphasize about preventing constipation ?

A

Stool softeners are taken on a regular basis during opioid use.

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27
Q

Which condition would cause the nurse to withhold a PRN order for magnesium hydroxide ?

A

chronic renal failure

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28
Q

Which are potential worrisome adverse effects associated with proton pump inhibitor use in older patients

A

-medication interactions
-osteoporosis
-vitamin and mineral deficiencies

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29
Q

A pts provider has recommended a bulk forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent ?

A

” I should take each dose with a full glass of water”

30
Q

A pt who is taking NSAIDs to treat arthritis asks the nurse why misoprostol has also been prescribed. Which explanation by the nurse is accurate ?

A

NSAIDs often cause GI irritation that can result in peptic ulcers

31
Q

Which symptom is the pt with lactase deficiency most likely to exhibit?

A

Diarrhea

32
Q

Pt who takes non-steroidal anti-inflammatory drugs (NSAIDs) for arthritis asks a nurse what can be done to prevent ulcers. The nurse will recommend asking the provider about using which medication?

A

Proton pump inhibitors

33
Q

Which are classified as one of the five major categories or laxatives ?

A

-Bulk forming laxatives
-Lubricant laxative
-Stimulant laxative
-Stool softeners

34
Q

The nurse is caring for 27 yr old pt taking a cannabinoid during chemotherapy. Which consideration will the nurse take into account?

A

Antihistamines may potentiate the effects

35
Q

A pt is diagnosed with Zollinger-Ellison syndrome. Which medication does the nurse expect the provider to order for this patient ?

A

Ranitidine

36
Q

A friend reports using loperamide for continual diarrhea for a week since returning home from a vacation outside the country. Which is the nurse’s best response?

A

“I’d stop taking the Imodium and go in to see a health care provider immediately. You may have an infection in your intestinal tract”

37
Q

A pt has been taking psyllium two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do?

A

Palpate the patient’s abdomen and auscultate for bowel sounds.

38
Q

A postoperative appendectomy pt has a nasogastric tube and wonders why the previous nurse told him that he was receiving an IV “ulcer preventing” medication called ranitidine. The pt states that he has never had any stomach problems in his life. Which is the best response by the nurse?

A

“Because you are not eating after surgery, this medication will help reduce the hydrochloric acid your stomach is still secreting”

39
Q

Which instruction will the nurse include in the discharge teaching of a pt taking psyllium?

A

“Administer with a full glass of water”

40
Q

Which antiemetic drug class is reserved for pts with severe nausea and vomiting?

A

Cannabinoids

41
Q

The nurse would expect to administer which drug when treating hyperemesis gravidarum?

A

Metoclopramide

42
Q

Which drug for nausea and vomiting can cause decreased sweating and increased risk for overheating?

A

Prochlorperazine

43
Q

A pt is beginning the second round of high dose cisplatin. Severe, chemotherapy induced nausea and vomiting occurred following the first treatment, requiring 72 hours of continuous IV hydration. In addition to her chemotherapy regimen, which medication would be best to administer ?

A

Parental ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days

44
Q

Which signs and symptoms are consistent with dehydration ?

A

-Increased hemoglobin and hematocrit
-Mental confusion and excessive thirst
-Nonelastic skin turgor and delayed capillary filling

45
Q

An older adult is admitted through the emergency department with complaints of nausea, abdominal tenderness, and continual stooling. On assessment, the nurse notes abdominal distention, smearing of stool on undergarments, and hypoactive bowel sounds LUQ and LLQ. The

A

An impaction

46
Q

A pt with PUD asks the nurse about the action of prokinetic medications. Which explanation by the nurse is accurate ?

A

It increases the lower esophageal sphincter muscle pressure and peristalsis

47
Q

Which explanation by the nurse is accurate to include when teaching a patient who is beginning therapy for gastroesophageal reflux disease (GERD) with metoclopramide?A

A

“peristalsis is increased, so food is digested more quickly”

48
Q

When metronidazole is a component of the H.pylori treatment regimen, the pt must be instructed to do what ?

A

Avoid any alcoholic beverages

49
Q

The nurse is caring for a pt receiving palliative care with opioid induced constipation. Laxative therapy has been unsuccessful. in treating this pt. Which PRN medication should the nurse provide to best alleviate this type of constipation?

A

Methylnaltrexone

50
Q

The nurse is assessing a pt taking lactulose to treat chronic constipation. Which adverse effect should the nurse immediately report to the health care provider?

A

Abdominal tenderness

51
Q

What specific problem can develop in a pt who has been prescribed both a 5-HT3 receptor antagonist and a phenothiazine ?

A

Cardiac dysrhytthmias.

52
Q

A 6 yr old child has frequent constipation. The nurse provides teaching after the parent ask the nurse why the provider recommended using laxatives only when needed. Which statement by the parent indicates a need for further teaching?

A

“Frequent use of laxatives can cause diverticulitis”

53
Q

A prepared childbirth nurse educator is discussing potential discomforts during pregnancy with a group of women. When relaying information about and vomiting, the nurse will include which statement(s).

A

-Vomiting during pregnancy is more common among primigravidas.
-Nausea and vomiting during pregnancy can occur at any time of the day.

54
Q

The nurse is administering medication to various patients during morning medication pass. The patient at the lowest risk of having an adverse reaction is the patient receiving :

A

dexamethasone

55
Q

A patient reports taking an oral bisacodyl laxative for several year. The provider has suggested discontinuing the laxative, but the pt is unsure how to do this. The nurse will tell the patient to :

A

stop taking the laxative immediately and expected no stool for several days

56
Q

What is an advantage of using benzodiazepines as an an adjunctive treatment for nausea and vomiting associated with chemotherapy?

A

The antianxiety effect helps, in addition to reducing the frequency of nausea and vomiting.

57
Q

The nurse is preparing to administer medications and notes that a pt has sucralfate ordered qid. When is the best time to administer this medication?

A

1 hour before meals

58
Q

A pt taking metoclopramide for the last 6 months develops uncontrolled rhythmic movement of the face, lip smacking, and rapid or wormlike movements of the tongue. What is your best action?

A

Document the findings and contact the prescriber

59
Q

Which non pharmaceutical interventions can be used to reduce symptoms of gastroesophageal reflux disease?

A

Avoiding late-night meals, stopping smoking

60
Q

You are providing instruction to a pt about the use of a bulk-forming laxative for the treatment of constipation. Which statement should be included in the teaching plan for this pt?

A

“Take this drug with a full glass of water”

61
Q

You are caring for a pt who is taking a substance P/neurokinin1 (NK1) receptor antagonist. Which laboratory finding would suggest the pt is experiencing an adverse reaction to this class of drugs?

A

Decreased white blood cell count

62
Q

The nurse is planning to administer an antacid to a pt dx with PUD who will receive an H2 antagonist at 8:00 am. When is the most appropriate time for the nurse to provide the antacid to this pt?

A

2 hrs after the H2 antagonist

63
Q

A pt going on vacation asks the nurse what she can give her 3 yr old child who becomes car sick. Which response would be accurate?

A

-“position techniques such as placing the child facing forward and blocking out scenery through the side windows can be helpful”
-“I would check with the pharmacist regarding over the counter products available for young children”

64
Q

Which drug would be most effective for an obstetric patient who is complaining of constipation as a result of her enlarging uterus and use of prenatal vitamins ?

A

Lubricant laxative

65
Q

A pt admitted to the hospital has a hx of peptic ulcer disease. The pt takes ranitidine and sucralfate. The pt tells the nurse that discomfort is usually controlled but that symptoms occasionally flare up. What will the nurse do ?

A

Counsel the pt to avoid beverages containing caffeine

66
Q

A pt who has gastroesophageal reflux disease (GERD) receives a prescription for a proton inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug?

A

“You should report any fever and cough to your provider”

67
Q

A pt is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notes that the pt abdominal is distended and firm, and hypoactive bowel sounds are present. The pt has not had a stool for 3 days. The nurse will contact the provider, who will:

A

perform diagnostic tests

68
Q

Which factors prevents breakdown of the body’s normal defense barriers that protect against ulcer formation?

A

-Prostaglandins
-Mucous cells

69
Q

Which statement made by a pt taking a H2-receptor blocker for peptic ulcer disease leads you to suspect the patient needs additional teaching regarding taking this class of drugs?

A

“I will take my daily dose of this drug first think in the morning”

70
Q
A

Pharmacology (11 decks)

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